U.S. patent number 4,616,651 [Application Number 06/768,532] was granted by the patent office on 1986-10-14 for surgical clip applier instrument adapter jaws.
This patent grant is currently assigned to Ethicon, Inc.. Invention is credited to Donald M. Golden.
United States Patent |
4,616,651 |
Golden |
October 14, 1986 |
Surgical clip applier instrument adapter jaws
Abstract
An adapter assembly is provided for a medical instrument
designed to apply a first ligating clip which has a first exterior
configuration. The adapter assembly is provided with an adapter
member associated with each jaw of the instrument to accommodate a
second ligating clip having a second exterior configuration
different than that of the first clip. Each adapter member has
structure for engaging a portion of one of the jaws and structure
is provided for attaching the adapter assembly to at least one of
the jaws in a fixed orientation with each adapter member extending
beyond the tip of the jaws. Each adapter member includes a clip
applying portion having a configuration adapted to cooperate with
the other adapter member to receive, hold, and apply the second
clip.
Inventors: |
Golden; Donald M. (Cherry Hill,
NJ) |
Assignee: |
Ethicon, Inc. (Somerville,
NJ)
|
Family
ID: |
27110832 |
Appl.
No.: |
06/768,532 |
Filed: |
August 22, 1985 |
Related U.S. Patent Documents
|
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
|
723602 |
Apr 15, 1985 |
4570633 |
|
|
|
306436 |
Sep 28, 1981 |
|
|
|
|
Current U.S.
Class: |
606/142;
606/158 |
Current CPC
Class: |
A61B
17/128 (20130101) |
Current International
Class: |
A61B
17/128 (20060101); A61B 17/12 (20060101); A61B
017/12 () |
Field of
Search: |
;128/33R,321,322,325,346,337,311,326 ;227/DIG.1,143 ;72/410,481
;81/421,422,423,424,418 ;29/243.56 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
128942 |
|
Mar 1902 |
|
DE2 |
|
515205 |
|
Nov 1920 |
|
FR |
|
Primary Examiner: Apley; Richard J.
Assistant Examiner: Macey; H.
Attorney, Agent or Firm: Minier; Robert L.
Parent Case Text
This is a division of application Ser. No. 723,602 filed April 15,
1985 now U.S. Pat. No. 4,570,633, which is a continuation patent
application of patent application Ser. No. 306,436, filed Sept. 28,
1981, now abandoned.
Claims
What is claimed is:
1. In a medical instrument for applying a first type of ligating
clip wherein said first type of clip has an extension configuration
adapted to be engaged by said instrument and wherein said
instrument includes two pivotally connected actuating members, each
having on one end a handle and on the other end a jaw for
receiving, holding, and applying said first type of clip, each of
said jaws defining a channel disposed in confronting relationship
with the channel of the other jaw and extending rearwardly from the
tip of the jaw, each said jaw including a side wall defining each
side wall of the jaw channel, each jaw having a partially
cylindrical recess extending across the width of the jaw channel to
each jaw side wall, a bore defined through each said jaw side wall
in registry with said partially cylindrical recess, the improvement
comprising:
an adapter assembly provided with a first and second adapter member
associated with each said jaw, respectively, to accommodate a
second type of ligating clip having an extension configuration
different than that of said first type of clip;
said first member being releasably secured to the channel in one of
said jaws and said second member being releasably secured to the
channel in the other of said jaws; each said adapter member being
inserted in one of said channels; and
each adapter member including a clip applying means disposed on the
portion of the adapter member extending beyond the tip of each jaw
member, said applying means being in facing relationship and
adapted to receive, hold and apply said second type of clip.
2. The improvement in accordance with claim 1 further characterized
in that said first and second adapter members of the adapter
assembly are joined in a V-shape configuration with the joined
portion of the V adjacent the cylindrical recesses.
3. The improvement in accordance with claim 2 wherein the adapter
assembly is spring steel.
Description
TECHNICAL FIELD
This invention relates, in general, to an instrument for applying
surgical clamps or clips, and more particularly, to an adapter jaw
structure for use with such an instrument.
BACKGROUND OF THE INVENTION
Clips have been devised for clamping or strangulating various
organs or vessels. For example, a clip and applicator for applying
the clip to a Fallopian tube is disclosed in U.S. Pat. No.
4,169,476. A clamp and applicator for applying the clamp to a bowel
is disclosed in U.S. Pat. No. 3,916,908. An example of a surgical
clip applicator which incorporates a disposable cartridge is
disclosed in U.S. Pat. No. 4,152,920.
Clips have been developed for use specifically in clamping or
strangulating blood vessels in the human body. The clips may be
fabricated from absorbable or nonabsorbable polymeric materials.
Examples of such clips, and of instruments for applying such clips,
are disclosed in U.S. Pat. Nos. 3,270,745; 3,326,216; 3,867,944;
3,631,707; 3,439,523; 3,439,522; 3,363,628; and 3,312,216.
In addition, various novel ligating clips are disclosed in U.S.
patent applications assigned to the assignee of the present
invention; Ser. No. 49,376, filed June 18, 1979, now abandoned;
Ser. No. 49,379, filed June 18, 1979, now abandoned; and Ser. No.
123,878, filed Feb. 25, 1980, now abandoned. The assignee of the
present invention has also developed an improved clip applier
instrument specifically adapted for applying one of these types of
ligating clips. The improved applier is disclosed along with the
clip in the above-identified U.S. patent application Ser. No.
49,379, now abandoned. The inventor of the present invention has
determined that it would be desirable to provide that improved clip
applier with the capability for applying ligating clips of
different designs.
SUMMARY OF THE INVENTION
A preferred embodiment of the present invention is incorporated in
the medical instrument for applying a first type or kind of
ligating clip. The first type of clip has an exterior configuration
adapted to be engaged by the instrument.
The instrument includes two pivotally connected actuating members,
each having on one end a handle and on the other end a jaw. Each
instrument jaw defines a channel disposed in confronting
relationship with the channel of the other jaw and extends
rearwardly from the tip of the jaw for receiving, holding, and
applying the first clip.
An adapter assembly is provided for the jaws to accommodate a
second type or kind of ligating clip that has an exterior
configuration different than that of the first clip. The adapted
assembly has means for engaging or receiving a portion of each of
the jaws. Means is provided for attaching the adapter assembly to
the instrument in a fixed orientation extending beyond the tip of
each jaw.
The adapted assembly includes two adapter members that each have a
clip applying portion with a configuration adapted to cooperate
with the other adapter member to receive, hold, and apply the
second type of clip.
The adapter assembly thus permits a single applier instrument to be
used with more than one type of clip and eliminates the need to
provide a number of complete new applier instruments.
The apparatus of the present invention resides in the novel
combination, construction, arrangement, and disposition of various
component parts and elements incorporated in the apparatus in
accordance with the principles of this invention.
The present invention will be better understood and important
features other than those specifically enumerated above and will
become apparent when consideration is given to the following
details and description which, when taken in conjunction with the
annexed drawings, describes, discloses, illustrates, and shows
preferred embodiments of the present invention and what is
presently considered and believed to be the best mode of practicing
the principles of the invention. Other embodiments and
modifications may be suggested to those having the benefit of the
teachings herein, and such other embodiments and modifications are
intended to be reserved, especially as they fall within the scope
and spirit of the sub-joined claims.
BRIEF DESCRIPTION OF THE DRAWINGS
In the accompanying drawings forming part of the specification and
in which like numerals are employed to designate like parts
throughout the same,
FIG. 1 is a forceps-type instrument for applying a first type of
ligating clip;
FIG. 2 is a greatly enlarged, fragmentary, cross-sectional view
taken generally along the plane 2--2 in FIG. 1;
FIG. 3 is a greatly enlarged, fragmentary, top view of the upper
jaw of the instrument illustrated in FIG. 1;
FIG. 4 is a fragmentary, cross-sectional view taken generally along
the plane 4--4 in FIG. 3;
FIG. 5 is a greatly enlarged view in perspective of a novel
surgical clip for which the instrument illustrated in FIGS. 1-4 has
been designed;
FIGS. 6 and 8 are views similar to FIG. 5 but showing the clip
latched closed;
FIG. 7 is a view similar to FIG. 4 but showing the clip of FIGS. 5
and 6 located within the jaws of the instrument and being closed
about a blood vessel;
FIGS. 9-12 are perspective views of other forms of ligating clips
shown in their closed positions;
FIG. 13 is a perspective view of the front of the instrument of
FIG. 1 with the instrument closed and showing one form of the
adapter assembly of the present invention secured thereto;
FIG. 14 is a view similar to FIG. 13 but with the upper portion of
the adapter assembly jaw omitted to better illustrate interior
detail of the lower portion of the adapter assembly;
FIGS. 15, 16, and 17 are views similar to FIG. 14 but showing the
lower portions of second, third, and fourth embodiments,
respectively, of an adapter assembly of the present invention;
FIG. 18 is a greatly enlarged, side view of the instrument of FIG.
1 shown in a closed position with a fifth embodiment of the adapter
assembly of the present invention mounted thereon;
FIG. 19 is a cross-sectional view taken generally along the planes
19--19 in FIG. 18;
FIG. 20 is an enlarged, fragmentary, perspective view of the front
of the lower jaw of the instrument of FIG. 1 with some of the
structure cut away and shows a modification of the means for
mounting the adapter assembly of FIGS. 18 and 19 to the
instrument;
FIG. 21 is an exploded, fragmentary, perspective view of the front
portion of the instrument of FIG. 1 and shows a sixth embodiment of
the adapter assembly of the present invention;
FIG. 22 is a fragmentary, perspective view of the sixth embodiment
of the adapter assembly of the present invention shown mounted
within the instrument of FIG. 1 and in an open position with a clip
of the type illustrated in FIG. 12 disposed within the adapter
assembly; and
FIG. 23 is a fragmentary, side elevational view of the adapter
assembly illustrated in FIG. 22 with the adapter assembly shown in
a closed position to close the clip about a blood vessel.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
This invention may be used in many different forms. The
specification and the accompanying drawings disclose specific
embodiments as examples of the use of the invention. The invention
is not intended to be limited to the embodiments illustrated, and
the scope of the invention will be pointed out in the appended
claims.
The precise shapes and sizes of the components herein described are
not essential to the invention unless otherwise indicated. The
particular shapes and sizes are shown to best illustrate the
principles of the invention.
The choice of materials for constructing the illustrated apparatus
is dependent upon the particular application involved and other
variables, as those skilled in the art will appreciate. In the
following description, three digit numerals in the 100 series are
used to refer to the first embodiment of the adapter assembly
illustrated in FIGS. 13 and 14, three digit numerals in the 200
series are used to refer to the second embodiment illustrated in
FIG. 15, three digit numerals in the 300 series are used to refer
to the third embodiment illustrated in FIG. 16, three digit
numerals in the 400 series are used to refer to the fourth
embodiment illustrated in FIG. 17, three digit numerals in the 500
series are used to refer to the fifth embodiment illustrated in
FIGS. 18 and 19 and to the modification of the fifth embodiment
illustrated in FIG. 20, and three digit numerals in the 600 series
are used to refer to the sixth embodiment illustrated in FIGS.
21-23. The same last two digits in each numeral designates similar
or functionally analogous elements in the various embodiments.
In the preferred form of the invention disclosed herein, the
invention is designed to be incorporated in, or made part of, a
modification of the forceps-type ligating clip applier disclosed in
the above-identified U.S. patent application, Ser. No. 49,379, now
abandoned. The modified forceps-type ligating clip applier is
illustrated in FIG. 1 in the drawings of this disclosure and is
designated generally therein by reference numeral 30.
The applier 30 comprises two actuating members or handle members 31
and 32 crossing at a pin or hinge point 33 and maintained in a
normally open position by a spring 38 which is secured by suitable
means, such as a rivet 38A, to the handle 31. The handle 31 extends
beyond the hinge point 33 to form a jaw member or jaw 34.
Similarly, the handle 32 extends beyond the hinge point 33 to form
a jaw member or jaw 35.
As best illustrated in FIGS. 2, 3, and 4, jaws 34 and 35 are of
identical design. Jaws 34 and 35 are provided respectively with
channels 36 and 37 extending rearwardly from the tips of the jaws.
In the lower jaw 34, the channel 36 is defined between the two
spaced-apart upwardly extending walls 50 and 51. Similarly, the
upper jaw 35 has two spaced-apart downwardly extending walls 60 and
61 which define the sides of the channel 37.
The channel 37 of the upper jaw 35 is provided with a partially
cylindrical recess 39 extending across the width of the channel.
Similarly, the channel 36 of the lower jaw 34 is provided with a
partially cylindrical recess 38 extending across the width of the
channel. The recesses 38 and 39 are generally in alignment when the
jaws of the instrument are closed and are sized to receive portions
of a ligating clip described in detail hereinafter.
In the preferred form of the instrument 30 illustrated in FIG. 1,
the instrument is fabricated from a suitable type of stainless
steel and the recesses 38 and 39 are formed in the jaws 34 and 35,
respectively, by drilling a hole through each jaw. As illustrated
for the upper jaw 35 in FIGS. 2 and 3, this drilling produces a
bore 63 in the wall 60 and a bore 64 in the wall 61. The bores 63
and 64 are coaxially aligned and are formed by a single drilling
operation that also forms the partially cylindrical recess 39.
Similarly, in the lower jaw 34, bores 53 and 54 are formed in the
walls 50 and 51, respectively, along with the recess 38 by drilling
through the jaw.
When the instrument 30 is fabricated from the stainless steel, it
is preferable to form the partially cylindrical recesses 38 and 39
in the jaws of the instrument by means of drilling through the jaw
walls as described above. However, the instrument 30 may be
fabricated from other materials, such as from molded thermoplastic
polymer compounds. With such a construction, the partially
cylindrical recesses 38 and 39 may be molded directly into the jaws
34 and 35, respectively. This would eliminate any need to drill the
sidewalls of the jaws to form the recesses. Consequently, jaw
sidewall bores would not be present in such an instrument.
In any case, the instrument 30 functions to apply a novel ligating
or hemostatic clip to close a severed blood vessel or other small
fluid duct. The novel clip is illustrated in FIGS. 5 and 6 and is
designated generally therein by the reference numeral 10A. In FIG.
5, the clip 10A is shown in an open position and in FIG. 6 the clip
is shown in a latched closed position.
With continued reference to FIGS. 5 and 6, the clip 10A is seen to
be formed with two leg segments 11 and 12 connected at the proximal
ends thereof by a hinge section 13. The leg segment 11 terminates
at the distal end thereof in a hook member 14 having an inner face
15 substantially parallel to an inner face 16 of the leg 11 segment
and forming an acute angle with an end face 17.
The leg segment 12 terminates at the distal end in an end face 19
which forms an obtuse angle with an inner face 18 of the leg
segment 12. The end face 19 is offset at 23 to form a notch
approximately midway between the inner face 18 and a bottom face
20. Additionally, the leg segment 12 is squared off at a face 25 to
form a substantially right angle with the bottom face 20.
The length and width of the inner faces 16 and 18 are substantially
equal and the face 15 of the hook member is spaced from the inner
face 16 of the leg segment 11 by a distance corresponding to the
thickness of the leg segment 12 between the planes of the inner
face 18 and the bottom face 20.
When the leg segments 11 and 12 are pivoted about the hinge section
13 to bring the inner faces 18 and 16 into opposition, the hook
member 14 is deflected by the end face 19 of the leg segment 12
until the distal end of the leg segment 12 snaps under the hook
member 14 and is thereby locked in place as best illustrated in
FIG. 6. The end face 17 of the hook member 14 and the end face 19
of the leg segment 12 are angled as illustrated in FIG. 5 to
facilitate the passage of the leg segment 12 past the hook member
14 during clip closure.
The surfaces of the inner faces 16 and 18 may be smooth as
illustrated in FIG. 5, or may be provided with ridges or grooves to
increase vessel holding power. The leg segment 11 may also be
undercut at the juncture of the hook member 14 and the inner face
16 as illustrated in FIG. 5 to increase the deflectability of the
hook member 14 and increase the space between the hook member 14
and the leg segment 11. This compensates for any inward deflection
of the hook member 14 during closure which might reduce the
clearance between the surfaces 15 and 16 and otherwise interfere
with the latching of the clip.
With continued reference to FIGS. 5 and 6, the leg segment 12 of
the clip 10A includes an outside cylindrical boss 21 extending
across the width of the leg segment 12 near the distal end thereof.
Similarly, the leg segment 11 has a boss 22 extending across the
width of the leg segment 11 near the distal end thereof. The
cylindrical bosses 21 and 22 are equidistant from the hinge section
13 so that when the clip 10A is closed, the bosses 21 and 22 define
a line perpendicular to the major axis along the length of the clip
as best illustrated in FIG. 6. The boss 21 is spaced from the face
25 a distance sufficient to permit the full engagement of the hook
member 14 by the leg segment 12 when the clip 10A is in the closed
and latched position.
The distal end of the leg segment 12 forward of the boss 21 is of
reduced thickness relative to the thickness immediately to the rear
of boss 21, thereby forming a step 24 between the boss 21 and the
bottom surface 20. The significance of this clip configuration will
be appreciated in connection with the description hereinafter of
the application of the clip by means of the instrument 30.
The instrument 30 is used to apply one clip 10A at a time to a
blood vessel or other fluid conduit. Initially, the clip 10A is
loaded in the clip applier instrument 30 when the instrument 30 is
in the open position as illustrated in FIGS. 1 and 4. After moving
the jaws of the instrument and the clip into position over the
vessel to be ligated, the jaws of the instrument are closed as
illustrated in FIG. 7 and the clip is locked into position over the
vessel 27. As can be seen in FIG. 7, the clip boss 22 is received
in the partially cylindrical recess 39 of the instrument upper jaw
35 and the clip boss 21 is received in the partially cylindrical
recess 38 of the instrument lower jaw 34.
As best illustrated in FIGS. 4 and 7, the portions of the
instrument channels 36 and 37 forward of the recesses 38 and 39,
respectively, are deeper than the portions of the channels behind
the recesses. When the open clip is held in the instrument 30, the
bosses 21 and 22 extend into the cylindrical recesses in each jaw
and, due to the angle of the open clip in the open instrument 30,
the distal ends of the leg segments of the clip extend into the
deeper forward channel portions of the instrument jaws. The reduced
thickness of the leg segment 12 of the clip at the distal tip
prevents interference between the tip of the clip 10A and the
channel 36 of the lower jaw 34 when the clip 10A is held in the
open position.
As the instrument 30 is operated to close the clip 10A, the bosses
21 and 22 rotate in the cylindrical recesses of the jaws 34 and 35,
respectively, until the outer surface of the leg segment 12 rests
on the rear portion of the bottom of channel 36 as illustrated in
FIG. 7. At this point, the distal end of leg segment 12 has rotated
away from the face of the channel 36 and a sufficient space exists
for the hook member 14 to bypass the leg segment 12 and latch over
the outer surface thereof.
After the clip 10A has been securely latched over the vessel 27,
the jaws 34 and 35 of the instrument 30 are opened to release the
clip 10A and the vessel 27. A new clip may then be loaded into the
instrument 30. Since the jaws of the applier 34 and 35 are
identical, it is not necessary to orient each jaw of the instrument
30 to a specific leg of the clip when loading the instrument
30.
The clip 10A illustrated in FIGS. 5-7 can be constructed in various
sizes according to its intended function. Hemostatic clips are
typically less than 6 mm in length, are about 1.5 mm in width, and
have a vessel clamping surface of about 3 mm in length. The
dimensions of the clip may be reduced about 50% for certain
applications in microsurgery. Larger clips for special hemostatic
applications, or for other functions such as the closure of
oviducts or vas-deferens, may have dimensions of about double those
of a typical hemostatic clip. The various sizes of clips are
preferably matched with individual appliers having jaws tailored to
the size of the clip for the best performance.
The clips are most conventionally molded of biologically acceptable
plastic materials which may be absorbable or non-absorbable.
Preferred absorbable polymers include homopolymers and copolymers
of glycolide and lactide, and poly(p-dioxanone). Preferred
non-absorbable polymers include nylon and polypropylene. All these
materials have been demonstrated to be biologically acceptable when
used as sutures or other implantable medical devices. The clips may
also be cast or machined from solid polymeric materials or from
metals such as aluminum, magnesium, stainless steel, tantalum, and
various alloys of these, some of which may also be absorbable in
biological tissue.
Other types of clips have been proposed for use in clamping blood
vessels and other fluid conduits in the human body. Some other clip
configurations are illustrated in FIGS. 9-12 which are all drawn to
the same scale for convenient reference. Also, for comparision
purposes, FIG. 8 illustrates the above-discussed clip 10A of FIGS.
5 and 6 drawn to the same scale as the clips of FIGS. 9-12. These
other clip designs are described next. A description of a novel
adapter assembly for enabling the instrument 30 to apply the
various clips follows the description of the clips.
FIG. 9 illustrates a clip 10B which is similar to the clip 10A
illustrated in FIGS. 5, 6, and 8 but which is much wider. FIG. 10
illustrates a clip 10C which is similar to the clip 10A illustrated
in FIGS. 5, 6, and 8 but which is much longer. The exterior
configurations of clips 10B and 10C are thus different than the
exterior configuration of clip 10A to the extent that the clips are
of different lengths or thicknesses. However, clips 10B and 10C
function in the same manner as clip 10A.
FIG. 11 illustrates a clip 10D that latches closed in a manner
identical to that of the clip 10A described above with reference to
FIGS. 5, 6, and 8. However, the clip 10D has an exterior
configuration that is different than that of the clip 10A.
Specifically, the clip 10D has a leg segment 11D connected to a leg
segment 12D by means of a flexible section 13D. Leg segment 11D has
a channel or recess defined between two walls or rails 71 and 72.
The lower leg segment 12D has a similar configuration.
FIG. 12 illustrates a clip 10E which has an upper leg segment 11E
and a lower leg segment 12E which are connected together by a
flexible section 13E. The upper leg segment 11E has a cylindrical
recess or bore 74 opening to the top of the clip. Similarly, the
lower leg segment 13E defines a bore 75 communicating with the
bottom surface of the clip.
The inventor of the present invention has determined that it would
be desirable to provide means for modifying the clip applier
instrument 30 (FIG. 1) to provide the instrument 30 with the
capability for applying clips having an exterior configuration
different than that of the clip 10A (FIGS. 5, 6, and 8). It would
be desirable to provide means for enabling the instrument 30 to
apply the clips illustrated in FIGS. 9-12, as well as other clips.
To this end, the inventor of the present invention has invented a
novel adapter assembly for cooperating with the instrument 30. The
adapter assembly may be provided in a variety of forms to function
with a variety of different clips and enable the instrument 30 to
apply the various clips to a blood vessel or other duct.
FIG. 13 illustrates the instrument 30 with a first embodiment of a
novel adapter assembly 100 provided thereon. The adapter assembly
100 comprises a first or lower jaw adapter member 104 associated
with the instrument lower jaw 34 and a second or upper jaw adapter
member 105 associated with the instrument upper jaw 35. The adapter
members 104 and 105 are identical. The structure of each member 104
and 105 will be described with reference to FIG. 14 which
illustrates the lower adapter member 104 in detail.
The adapter member 104 is provided with means for engaging or
receiving a portion of the instrument lower jaw 34. Specifically,
the adapter member 104 has a pair of spaced-apart mounting walls
150 and 151 with rearwardly extending portions between which the
lower instrument jaw 34 is disposed. The mounting walls 150 and 151
each have an inner surface facing toward the inner surface of the
other mounting wall. At least a rear portion of the inner surface
of each wall 150 and 151 of the adapter member 104 is arranged in
face-to-face relationship with an exterior side surface of each
associated instrument lower jaw wall 50 and 51, respectively.
The adapter member 104 is either releasably or permanently secured
to the instrument 30 by attaching each of the spaced-apart walls
150 and 151 to the sides of the lower jaw 34. If desired, a
suitable high temperature or thermal setting glue may be used to
secure the adapter members to the instrument jaws. Alternatively,
the adapter members may be welded or soldered to the instrument
jaws as at 155. One or more rivits may also be used to secure each
adapter member to the instrument jaw as described in detail
hereinafter.
The forward portion of the adapter member 104 is provided with a
channel 136 which is wider than the channel 36 of the instrument
jaw 34. The channel 136 also has a partially cylindrical recess 138
extending across the channel between the walls 150 and 151. In the
embodiment illustrated, the recess 138 may be formed by drilling
through the walls 150 and 151 thereby forming bores 153 and 154 in
the walls 150 and 151, respectively. If the adapter member 104 is
fabricated from metal, such as stainless steel, the cylindrical
recess 138 is most conveniently formed by means of drilling whereby
the bores 153 and 154 are necessarily formed in the adapter member
walls 150 and 151, respectively. However, the adapter member 104
may be fabricated from a suitable thermoplastic polymer. In such a
case, the partially cylindrical recess 138 may be directly molded
into the structure and the bores 153 and 154 need not be drilled or
otherwise formed.
The channel 136 of the adapter member 104 is substantially wider
than the channel 36 of the instrument jaw 34. This will permit the
adapter member 104 to receive the wider clip 10B described above
with reference to FIG. 9. Also, the portion of the channel 136
forward of the recess 138 is deeper than the portion of the channel
behind recess 138. In this respect, the channel 136 of the adapter
member 104 is similar to the channel 36 in the lower jaw 34 of the
instrument 30 so as to properly accommodate the clip 10B as it is
latched closed.
The upper adapter member 105 of the adapter assembly 100 (FIG. 13)
has a structure identical to that of the adapter member 104
described above. Consequently, when the clip 10B is properly
positioned with the clip bosses received in the recesses of the
adapter members, the clip 10B may be applied to a blood vessel or
other duct in a manner identical to that described above for the
clip 10A with references to FIGS. 5, 6, and 7.
FIG. 15 illustrates a second embodiment of an adapter assembly for
the instrument 30. The second embodiment of the adapter assembly is
next described with reference to a first or lower adapter member
204 secured to the lower jaw 34 of the instrument 30 as illustrated
in FIG. 15. The second embodiment of the adapter assembly also has
a second or upper adapter member (not illustrated) associated with
the upper jaw of the instrument 30. The second embodiment of the
adapter assembly is designed for use with the clip 10C described
above with reference to FIG. 10 and which is generally similar to
the clip 10A illustrated in FIGS. 5, 6, and 8 but which has a
greater length.
The adapter member 204 has a channel 236 that is similar in
configuration to the channel 36 of the lower jaw 34 of the
instrument 30 except that the channel 236 is longer than the
channel 36. The channel 236 has a recess 238 for receiving the boss
of the clip 10C. The adapter member 204 has walls 250 and 251 which
engage and receive the instrument lower jaw 34. The adapter member
204 is secured to the instrument lower jaw 34 by suitable means,
such as by a weld 255.
The upper adapter member of the second embodiment of the adapter
assembly is identical to the lower adapter member 204 illustrated
in FIG. 15. The upper and lower adapter members cooperate to
receive and to apply the clip 10C in the manner generally analogous
to that described above for the clip 10A with reference to FIGS. 5,
6, and 7.
FIG. 16 illustrates a third embodiment of the adapter assembly of
the present invention. The third embodiment of the adapter assembly
is illustrated and described with reference to a lower jaw adapter
member 304 which is identical to an upper jaw adapter member not
illustrated. The third embodiment of the adapter assembly is
designed for applying the clip 10D described above and designated
by the reference numeral 10D in FIG. 11.
The lower jaw adapter member 304 includes a pair of spaced-apart
parallel sidewalls 350 and 351 which cooperate together to receive
and engage the lower jaw 34 of the instrument. The lower jaw
adapter member 304 is mounted to the instrument lower jaw 34 by
suitable means, such as glue, adhesive, or a weld 355.
The lower jaw adapter member 304 includes a centrally disposed
upstanding guide rail 386 which is adapted to be received in the
slot of one of the leg segments of the clip 10D (FIG. 11). The rail
386 aligns the clip 10D on the instrument 30 and a friction fit
keeps the clip 10D in the instrument jaws until the clip is closed
about a vessel.
To insure that the front end of the clip 10D can be properly
latched, the adapter member 304 is provided with a downwardly
slanting surface 388 to provide appropriate clearance.
Though not illustrated, upstanding sidewalls may be provided on the
lower adapter member 304 on either side of, spaced from, and
parallel to, the rail 386. Such additional sidewalls would extend
forwardly from the existing instrument jaw walls 50 and 51 to form,
in effect, a continuation of the walls 50 and 51.
The third embodiment of the adapter assembly has an upper jaw
adapter member (not illustrated in FIG. 16) which is identical to
the lower jaw adapter member 304 and which cooperates with the
lower jaw adapter member 304 to receive, hold, and apply the clip
10D when the instrument 30 is actuated to close the instrument
jaws.
A fourth embodiment of the adapter assembly of the present
invention is illustrated in FIG. 17 with reference to a lower jaw
adapter member 404. The assembly also has an upper jaw adapter
member identical to the lower jaw adapter member 404 (not
illustrated in FIG. 17).
Specifically, the lower adapter member 404 has a pair of
spaced-apart parallel walls 450 and 451 which engage and receive
the front end of the instrument lower jaw 34. The lower adapter
member 404 is secured to the lower jaw 34 by suitable means, such
as by adhesive or by means of a suitable weld 455.
The lower jaw adapter member 404 includes a clip applying portion
having a configuration adapted to engage the clip illustrated in
FIG. 12 and designated generally therein by the reference numeral
10E. In particular, the lower jaw adapter member 404 includes a
channel of 436 for receiving one leg segment of the clip 10E.
Projecting upwardly from the channel 436 is a generally cylindrical
boss 489 which is adapted to be received in one of the cylindrical
bores or recesses of one of the leg segments of the clip 10E.
The upper jaw adapter member (not illustrated) has a structure
identical to that described above for the lower jaw adapter member
404. The two adapter members are designed to cooperate to receive,
hold, and apply the clip 10E.
FIGS. 18 and 19 illustrate a fifth embodiment of the novel adapter
assembly designated generally by the reference numeral 500. The
adapter assembly 500 includes an upper jaw adapter member 505 and a
lower jaw adapter member 504. The adapter assembly 500 is disclosed
to illustrate the novel means by which an adapter assembly may be
secured to the jaws 34 and 35 of the clip applier instrument 30.
However, the novel attachment means may be used with any of the
adapter assemblies described above with reference to FIGS.
13-17.
For purposes of illustration, the clip receiving portions of the
adapter assembly 500 have been simplified as best viewed in FIG. 19
for the lower jaw adapter member 504. Specifically, the lower jaw
adapter member 504 has a pair of spaced-apart widewalls 550 and 551
between which is defined a clip receiving channel 536. Depending
upon the particular configuration of the clip to be applied, the
lower jaw adapter member 504 would have a mating clip applying
portion with a configuration adapted to cooperate with the other
adapter member to receive, hold, and apply the particular clip. For
example, the front portion of the adapter member 504 may have a
configuration substantially identical to the front portions of any
of the lower jaw adapter members described above with reference to
FIGS. 14-17.
Regardless of the particular configuration of the clip applying
front portion of the adapter member 504, a novel structure is
provided for attaching the adapter member 504 to the lower jaw 34
of the instrument 30. Specifically, with continued reference to
FIGS. 18 and 19, the lower jaw adapter member 504 extends
rearwardly to receive and engage the front portion of the
instrument lower jaw 34. Each sidewall 550 and 551 is provided with
a bore, namely, bore 591, in sidewall 550 and bore 592 in sidewall
551. The bores 591 and 592 are in registry with the bores 54 and 53
in the instrument lower jaw 34. The bores 53 and 54 of the lower
jaw 34 are threaded and adapted to receive screws 593 and 594,
respectively. The bores 591 and 592 of the adapter member walls 550
and 551, respectively, are large enough to permit the passage of
the screws 593 and 594, respectively.
The upper jaw adapter member 505 of the adapter assembly 500 is
similarly secured to the upper jaw 35 of the instrument 30. The
upper jaw adapter member 505 has a configuration identical to that
of the lower jaw adapter member 504. The two adapter members 504
and 505 thus can cooperate to receive, hold, and apply a clip to a
blood vessel or other conduit when the instrument 30 is operated in
the usual manner described above.
The above-described jaw adapter member attachment structure avoids
the use of adhesive or welds. This has the advantage of permitting
the adapter assembly 500 to be easily removed from the instrument
if desired. Adapter assemblies for other types of clips could be
similarly secured to the instrument if desired.
FIG. 20 illustrates a modification of the means for attaching the
adapter members to the instrument 30. The modification is
illustrated specifically with reference to the lower jaw adapter
member 504 secured to the instrument lower jaw 34. Specifically,
the screws 593 and 592 of the structure illustrated in FIGS. 18 and
19 are replaced with a single rivit 596. The rivit is received
through the instrument jaw bores and engages the rearwardly
extending portions of the sidewalls 550 and 551 of the lower jaw
adapter member 504.
FIGS. 21-23 illustrate a sixth embodiment of the adapter assembly
of the present invention which is designated generally in those
Figures by the reference numeral 600. The adapter assembly 600 is a
unitary assembly that preferably compries a V-shaped piece of
spring steel. The assembly has a first or lower jaw adapter member
604 and a second or upper jaw adapter member 605. The adapter
assembly 600 is designed to be inserted within the channels of the
instrument lower and upper jaws 34 and 35 as illustrated in FIG.
22. Preferably, the assembly 600 is secured to at least one of the
two jaws by appropriate means, such as by glue, by adhesive, by
welding, or the like. A suitable glue 607 is shown in the
illustrated embodiment in FIG. 22 for securing the assembly 600 to
the jaws. Although the glue 607 is shown as applied to both jaws of
the instrument 30, the glue may be applied to only one of the
jaws.
In the embodiment of the adapter assembly 600 illustrated in FIGS.
21-23, the assembly 600 is designed to be used to apply a clip of
the type illustrated in FIG. 12 and generally designated in FIG. 12
by the reference numeral 10E. To this end, the lower jaw adapter
member 605 has an upstanding cylindrical boss 689 and the upper jaw
adapter member 605 has a downwardly extending cylindrical boss 690
(FIG. 21). The bosses are adapted to be received in the cylindrical
apertures of the clip 10E.
The clip 10E is positioned in the assembly 600 as illustrated in
FIG. 22 when the instrument 30 is in the open position. Proper
actuation of the instrument 30 to close the jaws causes the adapter
members 604 and 605 to move toward each other and to thereby latch
closed the clip 10E about a vessel or conduit 627 as best
illustrated in FIG. 23.
FIGS. 13-23 illustrate a number of embodiments of the adapter
assembly of the present invention. Each embodiment is illustrated
as having clip applying portions with a particular configuration
adapted to receive, hold, and apply a particular type of clip. It
is to be realized that the novel adapter assembly of the present
invention can include other configurations for the clip applying
portions, such other configurations having the shapes and
arrangements necessary to engage, receive, hold, and apply the
particular clips.
Although the instrument 30 has been illustrated as having bores 64
and 63 in the upper jaw 35 and bores 54 and 53 in the lower jaw 34,
it is to be realized that the novel adapter assembly of the present
invention may be provided for an instrument that is substantially
similar to the instrument 30 illustrated in FIGS. 1-3 but that does
not have the bores 63, 64, 53 and 54. In such a case, the adapter
assembly could be secured with adhesive or by welding as described
above with reference to FIGS. 14-17.
In addition, bores could be drilled into the instrument jaws to
permit use of the novel, removable connection structures described
above with reference to FIGS. 18-20.
From the foregoing, it will be observed that numerous variations
and modifications may be effected without departing from the true
spirit and scope of the novel concept of the invention. It is to be
understood that no limitation with respect to the specific
apparatus and method illustrated herein is intended or should be
inferred. It is, of course, intended to cover by the appended
claims all such modifications as fall within the scope of the
claims.
* * * * *